NPI | 1295830834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: WA MD00038809) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WA MD00038809) |
Enumeration Date | 2006-09-14 |
Last Update Date | 2011-12-09 |