| NPI | 1285781401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 37427) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 37427) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 37427) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2023-02-06 |