| NPI | 1518226000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0100263879) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL MD.33235) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D84689) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2021-12-15 |