| NPI | 1487283321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2025028054) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2025028054) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-05-21 |