| NPI | 1952416877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301055180) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301055180) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MI 4301055180) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2026-02-13 |