| NPI | 1952496291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 74418) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A74418) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-11-17 |