NPI | 1992083844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A14053) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q1131) |
208100000X Physical Medicine & Rehabilitation (Licence: TX BP10039391) | |
Enumeration Date | 2011-07-26 |
Last Update Date | 2021-12-17 |