| NPI | 1467031625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 71980) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31724) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-08-18 |