| NPI | 1134245913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 34.013816) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 056446) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-02-06 |