| NPI | 1942097217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 83264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-8994) |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2026-07-24 |