NPI | 1689136186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB11827000) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 328904) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2023-08-03 |