| NPI | 1427020890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 30444) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 30444) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2010-03-02 |