NPI | 1811155047 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DE C2-0011980) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA OS016086) |
208D00000X General Practice (Licence: DE C7-0003989) | |
Enumeration Date | 2008-05-23 |
Last Update Date | 2020-01-31 |