| NPI | 1194067223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 63536) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 63536) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2026-03-02 |