| NPI | 1437265717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101253471) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 44532) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-01-31 |