| NPI | 1194913756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 252803-2) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA a95636) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2015-02-10 |