| NPI | 1134109572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A84674) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 227907) |
| 207X00000X Orthopaedic Surgery (Licence: CO CDRH.0066414) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME155808) | |
| 207X00000X Orthopaedic Surgery (Licence: SD 5161) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO CDRH.0066414) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2023-10-09 |