| NPI | 1447489828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS15485) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: WV 2758) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2025-05-14 |