| NPI | 1871152686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 010199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09974) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-02-05 |