| NPI | 1013536655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX W6810) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0074685) |
| 207X00000X Orthopaedic Surgery (Licence: TX W6810) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2026-07-08 |