| NPI | 1861464844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NM A-101394) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM A-101394) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2017-04-28 |