NPI | 1659457794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 25404) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 25404) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2023-07-26 |