| NPI | 1285086488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NE 37138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA MD-55621) |
| 207X00000X Orthopaedic Surgery (Licence: NE 37138) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 97216) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA MD-55621) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2025-10-13 |