| NPI | 1831659168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 91964) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 13298235-1205) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-05-03 |