| NPI | 1356374219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 39978) |
| Additional Taxonomies | 2081H0002X (Licence: NC 39978) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-11-13 |