| NPI | 1245501436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.152869) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0059851) |
| 207X00000X Orthopaedic Surgery (Licence: TN 59285) | |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2025-05-21 |