| NPI | 1689793648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD429667) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DE C1-0009659) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2013-01-31 |