| NPI | 1922204536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 4593) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 4593) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2014-12-22 |