| NPI | 1366494809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 6195) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 34857) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 25154) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ND 6195) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 34857) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 25154) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-06-30 |