| NPI | 1689017584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM NM2017-0149) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 254527) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2018-12-16 |