| NPI | 1699832485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MA 236757) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 236757) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-10-28 |