| NPI | 1144540261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0101259517) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101259517) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116022535) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2016-07-18 |