NPI | 1780704593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301088725) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301088725) |
Enumeration Date | 2007-03-29 |
Last Update Date | 2022-02-17 |