| NPI | 1497877484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101247269) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: VA 0101247269) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0101247269) | |
| 246QM0706X Spec/Tech, Pathology, Medical Technologist | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-11-19 |