NPI | 1649731951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 295208) |
Enumeration Date | 2019-03-28 |
Last Update Date | 2023-05-06 |