| NPI | 1114979507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: HI 13514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0430058) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: HI 13514) | |
| 208D00000X General Practice (Licence: HI 13514) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-05-26 |