| NPI | 1205824265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME61914) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MS 19219) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MS 19219) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2018-12-07 |