| NPI | 1659379733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL DO284) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AL 7548) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2022-09-09 |