| NPI | 1487745808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 108707) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: CA 108707) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2021-11-29 |