| NPI | 1528379955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 51470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244469) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2015-12-04 |