| NPI | 1467534347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301405018) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: MI 4301405018) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MI 4301405018) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301405018) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-12-06 |