| NPI | 1174554398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101260383) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A80125) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0082026) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DC MD044561) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 2010-01313) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-04-18 |