| NPI | 1417301789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME157005) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD 2772) |
| 207X00000X Orthopaedic Surgery (Licence: AL MD.42241) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.42241) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2022-11-22 |