| NPI | 1659328862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 069002) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AR E4081) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2015-11-23 |