| NPI | 1487602314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 18550) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 18550) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 18550) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-10-12 |