| NPI | 1063451391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 027054) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 027054) |
| 207X00000X Orthopaedic Surgery (Licence: AL 13386) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.13386) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-11-20 |