| NPI | 1316232689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX Q9705) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.35014) |
| 207X00000X Orthopaedic Surgery (Licence: TX BP10039662) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-06-18 |