| NPI | 1316384068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: OR DO210351) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OR DO210351) |
| 208100000X Physical Medicine & Rehabilitation (Licence: ID O-1241) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2022-08-01 |