NPI | 1225263163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WA OP60266371) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207X00000X Orthopaedic Surgery (Licence: WA OP60266371) | |
Enumeration Date | 2009-05-21 |
Last Update Date | 2015-02-18 |