| NPI | 1316980972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV 10552) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CO DR.0046130) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2026-06-04 |