NPI | 1285819821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 303015) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 064735) |
208M00000X Hospitalist (Licence: GA 064735) | |
Enumeration Date | 2008-01-02 |
Last Update Date | 2020-01-28 |