NPI | 1225236672 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 233494) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A100528) |
Enumeration Date | 2007-07-06 |
Last Update Date | 2016-06-17 |