NPI | 1376858829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2081H0002X (Licence: CA A119877) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A119877) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2022-09-14 |