| NPI | 1427017698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NE 22219) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA MD-34883) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NE 22219) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA MD-34883) | |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-34883) | |
| 207X00000X Orthopaedic Surgery (Licence: NE 22219) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-06-23 |