| NPI | 1316901861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: CA G35064) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA G35064) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2010-09-08 |