| NPI | 1619996451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NC 2006-00544) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2006-00544) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-04-29 |