| NPI | 1346270881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME104621) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 24060) | 
| 207X00000X Orthopaedic Surgery (Licence: FL ME104621) | |
| Enumeration Date | 2006-07-03 | 
| Last Update Date | 2025-07-28 |