| NPI | 1003889213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX S9453) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S9453) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA 40187) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2025-03-17 |