| NPI | 1841232691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: GA 57695) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AL MD.28249) |
| 207X00000X Orthopaedic Surgery (Licence: GA 057695) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-11-19 |