| NPI | 1558527408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 66316) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: HI 366070) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2022-12-16 |