| NPI | 1306089305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX Q5643) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2014002054) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2016-08-15 |