| NPI | 1265851265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 59437) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: TN 59437) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-03-10 |