| NPI | 1609161728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 47550) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 33684) |
| 207X00000X Orthopaedic Surgery (Licence: GA 47550) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME109799) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME109799) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2022-09-02 |