| NPI | 1336201375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2009013440) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 32148) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036-138635) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO 32148) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2009013440) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2025-04-24 |