| NPI | 1245699446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS17260) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL OS17260) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 5101026195) | |
| 208D00000X General Practice (Licence: FL OS17260) | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2022-08-12 |