NPI | 1477717072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA OP 60353188) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: WA OP 60353188) |
Enumeration Date | 2008-07-12 |
Last Update Date | 2021-04-29 |