NPI | 1386272136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL 43491) |
Additional Taxonomies | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: NJ 25MA12125100) |
Enumeration Date | 2020-03-28 |
Last Update Date | 2025-09-02 |