| NPI | 1992949770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS 23122) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 0034792) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2014-06-30 |