| NPI | 1609006279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301092998) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301092998) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301092998) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.121161) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 46095) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2014-10-21 |