| NPI | 1447466883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX M9359) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 45380) |
| 207X00000X Orthopaedic Surgery (Licence: TX M9359) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-08-14 |