| NPI | 1205963246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0042757) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 42757) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-03-23 |