| NPI | 1275725038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA PT00010238) |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: WA PT00010238) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: WA PT00010238) | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: WA PT00010238) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: WA PT00010238) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: WA PT00010238) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |