NPI | 1992232847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2021-01201) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 009080) |
208100000X Physical Medicine & Rehabilitation (Licence: SC 87617) | |
Enumeration Date | 2017-05-22 |
Last Update Date | 2024-04-15 |