| NPI | 1669933347 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 67005) | 
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: NC 2023-00693) | 
| Enumeration Date | 2019-03-26 | 
| Last Update Date | 2024-05-29 |