| NPI | 1144233602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 12262) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PR 12262) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2024-01-05 |