| NPI | 1497855456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.060118) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD21651) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-11-19 |