| NPI | 1437249398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: LA MD.07570R) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 07570R) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2011-09-09 |