| NPI | 1457441206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NV 7091) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NV 7091) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-09-23 |