| NPI | 1376583443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA MD066157L) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: PA MD066157L) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-09-10 |