| NPI | 1447694153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 216578) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 216578) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-05-15 |