NPI | 1245072289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 80350) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-13233) |
Enumeration Date | 2024-06-11 |
Last Update Date | 2025-07-30 |