| NPI | 1215916556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101-231887) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: VA 0101-231887) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: VA 0101-231887) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2011-02-09 |