| NPI | 1346349065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DE C10006810) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 77829) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA C54371) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2025-11-13 |