| NPI | 1851369789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: NY 211071-1) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 210086) |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: NY 211071-1) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2018-05-10 |