| NPI | 1396847448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 81712) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 41492) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2019-07-31 |