| NPI | 1447446778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR0069846) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA OL20000127) |
| 208100000X Physical Medicine & Rehabilitation (Licence: WA OP60104140) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2024-10-04 |