| NPI | 1518914910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0101258592) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX K4868) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2026-06-18 |