| NPI | 1962690487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME99900) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101263323) |
| 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: FL ME 99900) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2024-04-02 |