| NPI | 1588720544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WY 9749A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 28937) |
| 208M00000X Hospitalist (Licence: SC 85487) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-10-10 |