| NPI | 1992852693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NH 19815) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VT 042-0009179) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2024-03-08 |