| NPI | 1871545475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 987) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 05736) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: SC 987) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: GA 055736) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-09-25 |