| NPI | 1609041441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: CA C161882) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 243525) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA C161882) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2020-08-07 |