| NPI | 1164713681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 56174) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 300343) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 300343) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 56174) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2021-11-10 |