| NPI | 1144674300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV DO3823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2021015011) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 20A-20116) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV DO3823) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2025-04-22 |