NPI | 1306410642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 71931) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA Mt222970) |
Enumeration Date | 2021-05-19 |
Last Update Date | 2022-07-12 |