| NPI | 1790889285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 50315) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 50315) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-01-10 |