| NPI | 1366726804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: RI DO01151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 276680) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2023-02-17 |