| NPI | 1598970345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102202394) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2008-00242) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-04-18 |