| NPI | 1467440487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301102208) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA05407200) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 165156) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2021-03-31 |