| NPI | 1598729311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 230470) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 23047) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-01-27 |