| NPI | 1982693032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101054619) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101054619) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101054619) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2022-04-12 |