| NPI | 1992064026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA MD.308290) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 24984) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2018-07-18 |