NPI | 1952386518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB07701500) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 231625) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2023-03-07 |