NPI | 1861665952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D75705) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD445085) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2013-09-16 |