| NPI | 1013370824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D90183) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D90183) |
| 208D00000X General Practice (Licence: PA MD467364) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-04-23 |