| NPI | 1124054770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: MA 150080) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 150080) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-08-24 |