| NPI | 1497865414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MA 75545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 12002) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 75545) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NH 12002) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-01-22 |