| NPI | 1265873194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 82388) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57023593) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2017041099) | |
| 207X00000X Orthopaedic Surgery (Licence: SC 82388) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2021-02-10 |