| NPI | 1023211794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 47908) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA a90878) |
| 207X00000X Orthopaedic Surgery (Licence: CO 47908) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2015-06-05 |