| NPI | 1619032315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 235174) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 238800-1) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MA 235174) | |
| Enumeration Date | 2006-12-25 |
| Last Update Date | 2021-02-19 |