| NPI | 1215223276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 078469) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 078469) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 55724) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-08-08 |