| NPI | 1760827901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.33858) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.33858) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NM MD2018-0146) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2019-06-06 |