| NPI | 1427093418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX K2314) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K2314) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2009-02-10 |