| NPI | 1770512311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 87424) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 87424) |
| 207X00000X Orthopaedic Surgery (Licence: SC 27593) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 27593) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-06-21 |