| NPI | 1922209675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME109477) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME109477) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-10-23 |