NPI | 1033679527 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0096819) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DC MTL005316) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2023-08-14 |