| NPI | 1568798452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PR 18676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18676) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2018-06-15 |