| NPI | 1144396987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS9993) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS006879L) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2016-07-15 |