NPI | 1508366592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: RI MD20010) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PR 36553) |
Enumeration Date | 2018-02-15 |
Last Update Date | 2024-05-21 |