| 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 |