| NPI | 1447254479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI 04203) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: RI RI4203) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2012-12-05 |