| NPI | 1134534761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 19897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-10103) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2020-07-23 |