| NPI | 1881822674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: KY 60925) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: TX BP30035033) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2025-08-08 |