| NPI | 1518185982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MT 11795) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD431276) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2011-10-28 |