| NPI | 1588082846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME146457) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 312088) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MI 4301104805) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-08-27 |