| NPI | 1568416493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 43793) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: CO DR.0043793) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2016-03-23 |