| NPI | 1841482502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS015167) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD P21938) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2017-01-25 |