| NPI | 1154709947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: NY 303790) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: IL 125.073489) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 303790) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2026-07-17 |