| NPI | 1508427329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS19943) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS19943) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2024-04-08 |