| NPI | 1437155942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J2336) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 26335) |
| 207X00000X Orthopaedic Surgery (Licence: SC 26335) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX J2336) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 26335) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 35268) | |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2022-04-05 |