| NPI | 1437685914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA MD477813) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 72026) |
| 208100000X Physical Medicine & Rehabilitation (Licence: WI 7636-851) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2024-10-03 |