| NPI | 1306337860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DE C2-0024445) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS022192) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-03-05 |