| NPI | 1417118365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: SC 30819) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 30819) |
| 207X00000X Orthopaedic Surgery (Licence: SC LL30819) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-07-21 |