NPI | 1487884052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.123988) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD197637) |
208VP0000X (Licence: OR MD197637) | |
Enumeration Date | 2009-07-17 |
Last Update Date | 2025-07-08 |