| NPI | 1487757043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA 09912R) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: LA 09912R) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: LA 09912R) | |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: LA 09912R) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2023-09-20 |