NPI | 1811928013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204R00000X Electrodiagnostic Medicine (Licence: AR E0060) |
Additional Taxonomies | 174400000X Specialist (Licence: AR E-0060) |
208100000X Physical Medicine & Rehabilitation (Licence: AR E0060) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2013-02-14 |