| NPI | 1144335951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD158150) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML20008591) |
| 207X00000X Orthopaedic Surgery (Licence: CO 50043) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-10-25 |