NPI | 1851433460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 020442) |
Additional Taxonomies | 174400000X Specialist (Licence: LA 020442) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2011-09-09 |