| NPI | 1619606035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 34.018651) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34.018651) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2026-06-19 |