| NPI | 1780979146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 304948) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R2714) |
| 207X00000X Orthopaedic Surgery (Licence: LA 304948) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2021-03-31 |