NPI | 1457468993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD24542) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA G84332) |
Enumeration Date | 2006-08-23 |
Last Update Date | 2007-07-08 |