NPI | 1629574173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D97011) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D97011) |
Enumeration Date | 2018-04-03 |
Last Update Date | 2024-09-14 |