| NPI | 1043205545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: FL 130640) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL 130640) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: FL 130640) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2024-10-09 |