| NPI | 1346413648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 61262) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MT191685) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2023-06-01 |