| NPI | 1700865359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV 6253) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 8968) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2011-05-09 |