| NPI | 1124048335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L0729) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX L0729) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: TX L0729) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: TX L0729) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |