NPI | 1811302771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS14304) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL UO4285) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2018-06-26 |