| NPI | 1568605780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 21490) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 258528) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NH 21490) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2024-03-06 |