NPI | 1053553255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX P6812) |
Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: TX P6812) |
Enumeration Date | 2009-04-02 |
Last Update Date | 2016-07-20 |