| NPI | 1639117807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 25464) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN MD00000038354) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 234254) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-03-30 |