| NPI | 1366423246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX K7496) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX K7496) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2021-03-23 |