NPI | 1710943451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: FL ME0085060) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME0085060) |
Enumeration Date | 2006-04-21 |
Last Update Date | 2011-10-28 |