| NPI | 1538128830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX H6004) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX H6004) |
| 207X00000X Orthopaedic Surgery (Licence: TX H6004) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2020-09-03 |