| NPI | 1477180776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: KY 60039) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 60039) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-06-09 |