| NPI | 1972738672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME151913) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301094151) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 51013) | |
| 207X00000X Orthopaedic Surgery (Licence: CA 129402) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2022-07-21 |