| NPI | 1144200106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM 97-2) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX J6846) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 46783) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 46783) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-08-09 |