| NPI | 1154369916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 46412) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: AL 23384) |
| 208100000X Physical Medicine & Rehabilitation (Licence: AL 23384) | |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CO 46412) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2009-03-03 |