NPI | 1275667230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ME MD17881) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MT186224) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2012-03-06 |