| NPI | 1174798847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2009-01425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 148705) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2014-05-02 |