| NPI | 1043400641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: OK 29497) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.202600) |
| 207X00000X Orthopaedic Surgery (Licence: SC 40807) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2021-03-16 |