| NPI | 1851561294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102202678) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: LA DO.000152) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD H0071194) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2023-10-24 |