| NPI | 1346704855 |
|---|---|
| Professional Name | ROBERT JACKSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: TX 2119678) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |