| NPI | 1841523529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 40483) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-240117) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IA MD40483) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 105713) | |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2020-06-29 |