NPI | 1740693704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101259131) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO dr.0069769) |
Enumeration Date | 2014-06-08 |
Last Update Date | 2023-11-08 |