| NPI | 1285016014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NE 31652) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7415) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-05-22 |