| NPI | 1457337107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101245575) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301091324) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101245575) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2022-04-02 |