NPI | 1629231477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME112183) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 232951) |
Enumeration Date | 2008-07-02 |
Last Update Date | 2012-06-22 |