| NPI | 1881630218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081H0002X Physical Medicine & Rehabilitation Hospice and Palliative Medicine (Licence: TX G4016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G4016) |
| 207X00000X Orthopaedic Surgery (Licence: TX G4016) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2012-07-17 |