| NPI | 1326345265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: AZ 47294) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: AZ 114) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2024-11-22 |