| NPI | 1417118431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 72725) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 072725) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2018-03-17 |