| NPI | 1295898542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR0072789) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 024535) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 024535) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2025-02-07 |