NPI | 1255378741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: MI 4301063401) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301063401) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2017-01-12 |