| NPI | 1053986281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 82658) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351047737) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2026-07-31 |