| NPI | 1427687839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KS 04-51679) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 69694) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-09-05 |