| NPI | 1881665347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ID M-14482) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 22780) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2021-07-16 |