| NPI | 1841483344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 29929) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 29929) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-11-23 |