| NPI | 1053807230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NE 9707) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AL L.4711) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2023-06-16 |