| NPI | 1902269293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 2022-02637) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 008703) |
| 207X00000X Orthopaedic Surgery (Licence: MA 286841) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 286841) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-09-22 |