| NPI | 1821052028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA MD024005) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME0088196) |
| 207X00000X Orthopaedic Surgery (Licence: LA MD.024005) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-04-19 |