| NPI | 1336123470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 2953) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102-201542) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101012100) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036.122301) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2015-11-14 |