| NPI | 1952817900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL 48277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01083985A) |
| 208M00000X Hospitalist (Licence: IN 01083985A) | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2024-10-07 |