NPI | 1871600148 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2008-02092) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 44811) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2022-02-17 |