| NPI | 1720306277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OK 32031) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX bp1-0037530) |
| 207X00000X Orthopaedic Surgery (Licence: TX Q3001) | |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2017-02-08 |