| NPI | 1023906153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2026015171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2025025437) |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2026-06-26 |