| NPI | 1932155991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301406116) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI P0406116) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-03-31 |