| NPI | 1386802072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 005226) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY R1268) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2024-04-04 |