| NPI | 1437147659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA MD.016690) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 10014) |
| 207X00000X Orthopaedic Surgery (Licence: LA MD.016690) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2017-04-18 |