NPI | 1881223881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2025036720) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A21127) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2025-08-26 |