| NPI | 1518073972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 321517) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CT 38363) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CT 038363) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2022-10-27 |