| NPI | 1831591221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX 45601) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX 44634) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2016-12-06 |