| NPI | 1518951110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NC 200200754) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200200754) |
| 207X00000X Orthopaedic Surgery (Licence: NC 200200754) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2022-02-24 |