| NPI | 1922204536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OK 4593) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 4593) | 
| Enumeration Date | 2007-06-21 | 
| Last Update Date | 2024-09-23 |