| NPI | 1821241530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX Q6978) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 243526) |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: PA MD478626) | |
| 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: TX Q6978) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2024-11-13 |