| NPI | 1407859226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME59819) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME59819) |
| 207X00000X Orthopaedic Surgery (Licence: GA 050854) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 050854) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-11-23 |