| NPI | 1063446748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0038656) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0038656) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-08-19 |