| NPI | 1952577751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NH 14493) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 229604) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2020-04-17 |