| NPI | 1235303330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 0053009) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CO 0053009) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2013-09-19 |