| NPI | 1144421876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2018039152) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: MO 2018039152) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX N3935) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-11-07 |