| NPI | 1326227901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A10323) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 245815) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2014-05-26 |