| NPI | 1174528202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 63648-21) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL OS9282) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101014350) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2015-03-26 |