NPI | 1366439572 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 14743R) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 26611) |
Enumeration Date | 2005-10-03 |
Last Update Date | 2013-03-30 |