NPI | 1740416965 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2009022188) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2009012806) |
Enumeration Date | 2009-06-02 |
Last Update Date | 2016-05-16 |