NPI | 1194704130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 16425) |
Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: SC 16425) |
Enumeration Date | 2006-01-10 |
Last Update Date | 2015-08-10 |