NPI | 1750378840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 37685) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NH 5978) |
Enumeration Date | 2005-10-04 |
Last Update Date | 2007-07-09 |