| NPI | 1023904513 |
|---|---|
| Former Name | ADAM MICHAEL JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: PA 1355292) |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-08-08 |