| NPI | 1346299112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NE 24181) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA MD-37183) |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-37183) | |
| 207X00000X Orthopaedic Surgery (Licence: WI 44869) | |
| 207X00000X Orthopaedic Surgery (Licence: NE 24181) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-06-24 |