| NPI | 1770530404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ME 1709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 1709) |
| 207R00000X Internal Medicine (Licence: MA 152398) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MA 152398) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: TN 3552) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: ME 1709) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: ME 1709) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2019-04-02 |