| NPI | 1841212917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102050101) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VA 0102050101) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2008-07-31 |