| NPI | 1376576421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 039067) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI 12523) |
| 207X00000X Orthopaedic Surgery (Licence: NY 196273-1) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 39067) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-12-21 |