| NPI | 1568418986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0042014) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: CO C042014) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-10-20 |