NPI | 1376571950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 26055) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 26055) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2012-10-25 |