| NPI | 1487696225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 057593) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 57593) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.28761) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-05-23 |