| NPI | 1013178284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 204614) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 204614) |
| 207X00000X Orthopaedic Surgery (Licence: LA PGY-1 Intern Permit) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2022-12-30 |