| NPI | 1447415161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OT012680) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: PA OS015070) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 006377) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MN 56152) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2014-05-09 |