| NPI | 1205350832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 95443) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 95443) |
| 208D00000X General Practice (Licence: GA 95443) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2024-03-26 |