| NPI | 1811013386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NV DO2448) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NV DO2448) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: CA 20A10836) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-12-01 |