NPI | 1083875462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 261383) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NH 16841) |
Enumeration Date | 2008-06-19 |
Last Update Date | 2024-11-12 |