NPI | 1548825524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 69616) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 261208) |
Enumeration Date | 2019-05-06 |
Last Update Date | 2024-07-08 |