NPI | 1083742563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301081925) |
Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MI 4301081925) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2019-06-24 |