| NPI | 1679731657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PR 22185) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME141332) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A155569) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2022-06-06 |