| NPI | 1851928089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD H0098979) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2026005467) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-02-23 |