| NPI | 1740817790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102208537) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0102208537) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-08-06 |