| NPI | 1922117019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NM 92-346) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NM 023934) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-10-23 |