| NPI | 1366420366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301101812) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47773) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2024-03-08 |