| NPI | 1770505786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA MD.11105R) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 11105R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-10-26 |