NPI | 1861478752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ID M-8613) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ID M8613) |
208100000X Physical Medicine & Rehabilitation (Licence: OH 35.075149) | |
208100000X Physical Medicine & Rehabilitation (Licence: TX U2417) | |
Enumeration Date | 2005-12-21 |
Last Update Date | 2024-01-02 |