| NPI | 1609092352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 53435) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 225600) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 249418) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-06-22 |