| NPI | 1124246566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX T2234) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101283929) |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: TX T2234) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2025-01-06 |