| NPI | 1992732002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081H0002X (Licence: KY 02145) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 02145) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2019-08-27 |