| NPI | 1326008954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301065411) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301065441) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2025-03-05 |