| NPI | 1063420750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: MD D59136) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: DC MD33523) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: TX L3375) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2015-04-01 |