| NPI | 1902983711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2014-01944) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL OS0005862) |
| 207X00000X Orthopaedic Surgery (Licence: FL OS5862) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-01-12 |