NPI | 1053387894 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: OR MD24985) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD24985) |
Enumeration Date | 2006-02-23 |
Last Update Date | 2022-12-22 |