| NPI | 1588221170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A177033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217349) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2022-12-16 |