| NPI | 1932369030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: SC 36781) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MA 254005) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2023-04-17 |