| NPI | 1295714038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA MD.09934R) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA 09934R) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MS 12544) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: AZ 53520) | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2023-11-02 |