| NPI | 1508272535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: DC DO034860) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: DC DO034860) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2022-10-26 |