| NPI | 1326057852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD199243) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 8253) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2017-00085) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 2017-00085) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-11-04 |