| NPI | 1629239108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: TX P2571) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX P2571) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: TX P2571) | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: TX P2571) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2025-12-10 |