NPI | 1457617011 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102204484) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 3034) |
Enumeration Date | 2012-04-09 |
Last Update Date | 2023-03-22 |