| NPI | 1588000798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IA MD-46519) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-46519) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IA MD-46519) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MN 59467) | |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2020-06-30 |