| NPI | 1326079955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 235598) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY ME96177) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-10-15 |