NPI | 1720293285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0101238424) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238424) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2025-07-11 |