| NPI | 1073547824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA a84894) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A84894) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA a84894) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-04-29 |