NPI | 1285621599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 81841) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NH 7008) |
Enumeration Date | 2005-10-03 |
Last Update Date | 2007-07-09 |