NPI | 1780616326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 23036) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME 130391) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2020-11-19 |