| NPI | 1154848349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 89820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 8024) |
| 207R00000X Internal Medicine (Licence: GA 89820) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2021-10-27 |