| NPI | 1821265687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: TX P6606) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX P6606) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2025-11-26 |