| NPI | 1154437937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2006015423) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 4871) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2019-05-14 |