| NPI | 1326049412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 36604) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 36604) |
| 207X00000X Orthopaedic Surgery (Licence: NC 36604) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2022-02-24 |