| NPI | 1790747350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 1794) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OK 1794) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OK 1794) | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: OK 1794) | |
| 207RI0001X Internal Medicine Clinical & Laboratory Immunology (Licence: OK 1794) | |
| 207RI0001X Internal Medicine Clinical & Laboratory Immunology (Licence: OK 37D2190466) | |
| 207ZP0105X Pathology Clinical Pathology/Laboratory Medicine (Licence: OK 37D2190466) | |
| 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: OK 1794) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: OK 1794) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-07-19 |