| NPI | 1033313556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX N6038) |
| Additional Taxonomies | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: TX N6038) |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: TX N6038) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-07-02 |