NPI | 1922045087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 31984) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX H6592) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2007-07-08 |