| NPI | 1659506459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.151575) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301094200) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: MI 4301094200) | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2024-12-31 |