NPI | 1043515430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: DC MD040040) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A104580) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2013-09-25 |