NPI | 1962727933 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NE 26425) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 63788) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-04-02 |
Last Update Date | 2022-07-21 |