| NPI | 1295998771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MT 73861) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2008016678) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2014015767) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 107054) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 56811) | |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2019-07-13 |