| NPI | 1407878846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101041068) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0101041068) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-01-11 |