| NPI | 1265465157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AR E-13056) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 35400) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: OK 32000) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-04-29 |