| NPI | 1710097282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: FL ME96790) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: FL ME96790) |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL ME96790) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-12-08 |