| NPI | 1376580530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MD D0062045) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MD D0062045) |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: MD D0062045) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD D0062045) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: MD D0062045) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2015-03-26 |