| NPI | 1649356072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2010-01328) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: SC LL28073) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-10-25 |