NPI | 1730881376 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 80266) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 80266) |
Enumeration Date | 2023-03-20 |
Last Update Date | 2025-08-01 |