NPI | 1902028939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0065957) |
Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MD D0065957) |
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD D0065957) | |
Enumeration Date | 2007-05-02 |
Last Update Date | 2008-05-20 |