| NPI | 1649288705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: SC 35074) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 35074) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2024-09-24 |