| NPI | 1295926731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME116919) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2007017340) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301100166) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301100166) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2015-03-23 |