| NPI | 1447740287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IA MD-49707) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NE 8229) |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2022-09-16 |