| NPI | 1851528988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: VA 0101248009) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101248009) |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: MD D0091395) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2024-07-09 |