NPI | 1982600656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 309021) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB63962) |
Enumeration Date | 2005-06-27 |
Last Update Date | 2018-12-20 |