| NPI | 1497917991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2011015519) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2011015519) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2011015519) | |
| 208600000X Surgery (Licence: NE 5914) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2020-11-18 |