| NPI | 1124225255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301090600) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AR E-7148) |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: MI 4301090600) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301090600) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-09-17 |