NPI | 1467870436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA12626000) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX R5506) |
Enumeration Date | 2014-04-07 |
Last Update Date | 2025-06-30 |