| NPI | 1578973517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 281804) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 264455) |
| 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: MA 281804) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2021-07-19 |