| NPI | 1225303043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101254748) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101254748) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2024-02-23 |