| NPI | 1336458207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX T1900) |
| Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation Brain Injury Medicine (Licence: TX T1900) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX T1900) | |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2024-07-03 |