| NPI | 1265645170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: CA C34677) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA C34677) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: FL C34677) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-05-16 |