| NPI | 1841426483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD451917) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301102158) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2014-09-15 |