| NPI | 1881645042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301063445) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: MI 207X00000X) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-07-12 |