NPI | 1841726999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0066585) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059508) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2021-08-10 |