NPI | 1639288137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME68779) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME68779) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2023-03-10 |