| NPI | 1861609067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0050014) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 068140) |
| 207X00000X Orthopaedic Surgery (Licence: CO 50014) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-11-29 |