| NPI | 1285695817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MO 2002011273) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX N7975) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2018-06-25 |