| NPI | 1467733352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: PA MD454327) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD454327) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2015-10-16 |