| NPI | 1033258058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NM MD2010-0085) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM 2004-0285) |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2010-0085) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-09-05 |