| NPI | 1689730608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q1756) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MD P24209) |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MT186724) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2025-10-23 |