| NPI | 1295920718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2008010710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 746000949) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2019-04-09 |