| NPI | 1568493237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: DC MD042792) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: DC MD042792) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MD D64138) | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MD D64138) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-02-11 |