| NPI | 1700370327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 94137) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4351041615) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-04-08 |