NPI | 1295222420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD210001827) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101273867) |
Enumeration Date | 2018-04-13 |
Last Update Date | 2023-11-09 |