| NPI | 1194352468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX V9872) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 30887) |
| 207X00000X Orthopaedic Surgery (Licence: MN 69559) | |
| 207X00000X Orthopaedic Surgery (Licence: TX V9872) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-06-16 |