NPI | 1144617499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0064796) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA OP60949092) |
Enumeration Date | 2015-04-23 |
Last Update Date | 2021-08-20 |