| NPI | 1225139116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD034484E) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME0063435) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2023-09-14 |