| NPI | 1144631896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0097985) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD046393) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2025-01-30 |