| NPI | 1558476234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OK 40171) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 58066) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-04-26 |