NPI | 1619400967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VT 042.0017017) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 318576) |
Enumeration Date | 2017-04-04 |
Last Update Date | 2023-07-18 |