| NPI | 1467563460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2017039277) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ID M12915) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-05-15 |