| NPI | 1467428920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME21555) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 21555) |
| 207X00000X Orthopaedic Surgery (Licence: GA 038960) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2015-03-25 |