| NPI | 1487008850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 91722) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.42347) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 91722) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2025-04-30 |