| NPI | 1346745767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX U9041) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX U9041) |
| 207X00000X Orthopaedic Surgery (Licence: MN 65995) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-10-08 |