| NPI | 1962412569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OK 11348OK) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OK 11348) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2009-06-19 |