| NPI | 1245216902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA 0S012248) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: PA OS012248) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2014-03-28 |