| NPI | 1851529168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD445698) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT195732) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2024-10-24 |