| NPI | 1215904156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: AK 5068) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AK 2454) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-02-18 |