| NPI | 1407881576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME69760) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME0069760) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL ME0069760) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: FL ME69760) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-10-28 |