| NPI | 1881686384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 51908) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD28004) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 051908) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 51908) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2023-05-03 |