| NPI | 1245277573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS 11542) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: MS 11542) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2015-07-14 |