| NPI | 1558524983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 67300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237328) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-04-16 |