| NPI | 1750384137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0101030806) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101030806) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2008-03-11 |