| NPI | 1598701138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD035704) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0061820) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101238989) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2016-07-01 |