| NPI | 1457544637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2008-00479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2008-00479) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2021-04-07 |