| NPI | 1679779276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL DO.1014) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.008380) |
| 207X00000X Orthopaedic Surgery (Licence: FL OS12882) | |
| 207X00000X Orthopaedic Surgery (Licence: KY 03290) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2014-08-15 |