| NPI | 1265790182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY R2935) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R2935) |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2024-01-25 |