NPI | 1922577006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NE 1705) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 094038) |
Enumeration Date | 2018-11-18 |
Last Update Date | 2018-11-18 |