| NPI | 1902224538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A167947) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A167947) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2023-08-22 |