| NPI | 1922597657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MA 1016119) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 1016119) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2023-08-03 |