| NPI | 1831188929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA MD078742) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MD D51290) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D51290) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: DC MD036431) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2022-07-21 |