| NPI | 1205888997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101046574) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101046574) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-08-14 |