NPI | 1316138845 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 061971) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 245314) |
Enumeration Date | 2007-08-08 |
Last Update Date | 2015-07-27 |