NPI | 1922456292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0067172) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A170611) |
Enumeration Date | 2016-05-27 |
Last Update Date | 2021-09-30 |