| NPI | 1578566147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 041688) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 041688) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2013-12-05 |