| NPI | 1235441619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2016026450) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 262262) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 3334618) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A138468) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: KS 04-36758) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2019-06-19 |