| NPI | 1437131232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC TL30301) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 054925) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-10-29 |