| NPI | 1194910398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: PR 17511) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PR 25818-r) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PR 17511) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2016-12-23 |