| NPI | 1164609566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 70208) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 002762) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2021-03-08 |