| NPI | 1871088849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0301X Physical Medicine & Rehabilitation, Brain Injury Medicine (Licence: FL OS17625) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 71250) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-01-19 |