NPI | 1982824090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 200400357) |
Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 200400357) |
Enumeration Date | 2007-04-30 |
Last Update Date | 2021-04-08 |