| NPI | 1699910950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS15213) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 9664) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL OS15213) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2021-03-25 |