NPI | 1720240955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 49512) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO 2547) |
Enumeration Date | 2008-06-29 |
Last Update Date | 2018-09-19 |