NPI | 1922341882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MI 5101023404) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101023404) |
Enumeration Date | 2013-03-29 |
Last Update Date | 2020-11-11 |