| NPI | 1467080358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 51120) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 79561) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 79561) | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2026-07-24 |