NPI | 1457970915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 336092) |
Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: NY 336092) |
Enumeration Date | 2020-04-14 |
Last Update Date | 2025-07-29 |