NPI | 1295990216 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: WA MD 60238525) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
208100000X Physical Medicine & Rehabilitation (Licence: WA MD 60238525) | |
2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: CA 146152) | |
Enumeration Date | 2008-07-20 |
Last Update Date | 2023-02-15 |