| NPI | 1396714960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY 26486) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 26486) |
| 207X00000X Orthopaedic Surgery (Licence: KY 26486) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2015-04-08 |