| NPI | 1962450031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A77281) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A77281) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2017-08-30 |