| NPI | 1043262140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MT 11437) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 6107573-1205) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2025-08-14 |