| NPI | 1235329434 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA 40609) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 54913) |
| 207X00000X Orthopaedic Surgery (Licence: IA 40609) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 036.131864) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2017-02-01 |