| NPI | 1932242542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0068884) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD038330) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-06-30 |