| NPI | 1770557571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 080386) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101233465) |
| 207X00000X Orthopaedic Surgery (Licence: WV 23156) | |
| 207X00000X Orthopaedic Surgery (Licence: WI 52777-20) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 45384) | |
| 207X00000X Orthopaedic Surgery (Licence: SC 52292) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2020-05-19 |