| NPI | 1649230483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0084370) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0084370) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101263219) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-07-15 |