NPI | 1245987973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MI PT20034012) |
Enumeration Date | 2022-03-02 |
Last Update Date | 2022-03-02 |