| NPI | 1427209444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101251096) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 24665) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0073464) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2013-02-01 |