| NPI | 1639359813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: HI 15519) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A101393) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2011-07-20 |