| NPI | 1477716348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301104001) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301104001) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2017-02-08 |