| NPI | 1376514190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA C54741) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: SD 1469) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 01075520A) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35141611) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MT 85785) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-03-25 |