| NPI | 1730192337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV 8808) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX H4529) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: NV 8808) | |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: TX H4529) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: NV 8808) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: TX H4529) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2015-02-23 |