| NPI | 1649332909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CT 21539) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 021539) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-10-10 |