| NPI | 1548498710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL 2944) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2013010094) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2022-12-06 |