| NPI | 1497848055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N7692) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX N7692) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-01-05 |