| NPI | 1003251851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WV 26378) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.36818) |
| 207X00000X Orthopaedic Surgery (Licence: WV 26378) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2021-11-16 |