| NPI | 1003834169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 201531) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 19439) |
| 207P00000X Emergency Medicine (Licence: LA 201531) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: MS 19439) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: LA 201531) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-04-21 |