| NPI | 1659833366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 02007853A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074919) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 33866) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 75957-21) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-10-02 |