| NPI | 1366684417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: DC MD041050) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D71281) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2024-09-05 |