| NPI | 1376075192 |
|---|---|
| Former Name | JARED RAY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: GA 92729) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY IP1557) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-09-23 |