| NPI | 1447644356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS18705) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL DO.2055) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2022-06-02 |