| NPI | 1134440399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA L-243820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME MD24278) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-02-22 |