| NPI | 1679570048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 25535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 25535) |
| 174400000X Specialist (Licence: AZ 25535) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2022-10-18 |