NPI | 1770926222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME136628) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 56212) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-15 |
Last Update Date | 2022-08-05 |