| NPI | 1467814350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: TX T0901) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI R300765115741) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-11-10 |