| NPI | 1477675494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: DC MD041346) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 14836) |
| 207X00000X Orthopaedic Surgery (Licence: MD D75814) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101253885) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 50876) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DC 041346) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-08-29 |