| NPI | 1942566872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A127924) |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine (Licence: CA A127924) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2019-10-14 |