| NPI | 1699727958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 46060) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 30252) |
| 207X00000X Orthopaedic Surgery (Licence: ND 9363) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ND 9363) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 46060) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 30252) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-05-13 |