| NPI | 1952537060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ID M-12854) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID M-12854) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35123184) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MT195504) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2020-02-24 |