| NPI | 1992817175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AK AA3013) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AK AA 3013) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-11-21 |