| NPI | 1275850836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q8692) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A121719) |
| 208100000X Physical Medicine & Rehabilitation (Licence: OK 42156) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2023-11-06 |