| NPI | 1750329728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 79478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 079478) |
| 207R00000X Internal Medicine (Licence: IL 036.115720) | |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: GA 079478) | |
| 208M00000X Hospitalist (Licence: GA 079478) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-06-25 |