| NPI | 1366977860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX U1157) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0068328) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX U1157) | |
| Enumeration Date | 2017-04-22 |
| Last Update Date | 2023-08-07 |