NPI | 1962468546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 71704) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q8336) |
2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX Q8336) | |
Enumeration Date | 2006-04-24 |
Last Update Date | 2024-10-22 |