| NPI | 1922418102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD N-250-098-799-167) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD465242) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2018-08-17 |