| NPI | 1871728493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-14713) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 10187A) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ID M-14713) | |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2020-03-16 |