| NPI | 1962703363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225500000X Specialist/Technologist |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |