| NPI | 1679613293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 0054944) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 230745) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 230745) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO 0054944) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MA 230745) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-05-21 |