| NPI | 1376742023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0080065) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101242418) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DC MD035534) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-06-06 |