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 |