NPI | 1861509846 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX E9171) |
Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX E9171) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2024-02-16 |