NPI | 1275586687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 159200) |
Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: NY 159200) |
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: NY 1592000) | |
208100000X Physical Medicine & Rehabilitation (Licence: NY 1592000) | |
Enumeration Date | 2006-05-18 |
Last Update Date | 2014-09-04 |