| NPI | 1255524435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2008-00177) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2008-00177) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2019-02-27 |