| NPI | 1033384946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MA 240602) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 240602) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: RI DO00751) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2019-12-09 |