| NPI | 1134154438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 10800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 12826) |
| 207X00000X Orthopaedic Surgery (Licence: NE 27856) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 12826) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-06-14 |