| NPI | 1457375438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS12483) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AR N-8253) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-07-30 |