| NPI | 1952349185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL 0S5596) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: FL OS5596) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-08 |