NPI | 1427378843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 56680) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA09886400) |
Enumeration Date | 2010-06-08 |
Last Update Date | 2018-09-21 |