| NPI | 1881957835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036.153799) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO TL0004864) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 88832) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 54168) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.140569) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO CDRH.0053510) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 308964) | |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2021-07-29 |