NPI | 1073538971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD427039) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 290802) |
208100000X Physical Medicine & Rehabilitation (Licence: MD D65463) | |
208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09061400) | |
Enumeration Date | 2006-07-12 |
Last Update Date | 2025-10-10 |