| NPI | 1699887018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 27956) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ND 5371) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-05-07 |