NPI | 1861029019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 72028) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 12409924-1205) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2024-07-08 |