| NPI | 1316172687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301093418) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ME 0180) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MI 4301093418) | |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2021-04-06 |