| NPI | 1831604552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 67463) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO TL.0006935) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: KY FT587) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NY P100406) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 306505-01) | |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2023-07-27 |