NPI | 1598961310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX N0278) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 059561) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2022-03-02 |