| NPI | 1023469293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 70647) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 70647) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2023-05-15 |