| NPI | 1902428576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 1902428576) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine (Licence: VA 0116034587) |
| Enumeration Date | 2020-05-17 |
| Last Update Date | 2026-06-15 |