| NPI | 1639348436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 41358) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A93007) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2024-02-28 |