NPI | 1396999652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 55978-21) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 715941-1204) |
Enumeration Date | 2008-11-12 |
Last Update Date | 2015-03-24 |