| NPI | 1538474861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0102204056) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102204056) |
| 207X00000X Orthopaedic Surgery (Licence: PA OT013640) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2020-11-13 |