| NPI | 1275821167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 54381) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 54381) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2023-09-25 |