| NPI | 1013041540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MN 52284) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: MN 52284) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2022-05-25 |