| NPI | 1659364990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 33827) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 33827) |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 33827) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: AZ 33827) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2020-09-08 |