| NPI | 1154565562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0101249365) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2025-03-27 |