NPI | 1871899740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD183687) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A112066) |
Enumeration Date | 2011-02-09 |
Last Update Date | 2018-05-17 |