NPI | 1669932752 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 81582-21) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074242) |
Enumeration Date | 2019-03-23 |
Last Update Date | 2024-07-17 |