NPI | 1609453950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IL 125081799) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.146550) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-24 |
Last Update Date | 2023-07-01 |