NPI | 1992328561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101287120) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 99132) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-05-18 |
Last Update Date | 2025-09-24 |