| NPI | 1437890720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KS 04-46120) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2023027000) |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2026-07-15 |