| NPI | 1861476947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: MA 214129) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 214129) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2012-09-07 |