| NPI | 1285235705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0077034) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0077034) |
| 207X00000X Orthopaedic Surgery (Licence: SC LL85134) | |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2026-08-03 |