| NPI | 1174722243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P8691) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MDR-5111) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P8691) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2025-06-06 |