| NPI | 1558351049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P7141) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 39357) |
| 207X00000X Orthopaedic Surgery (Licence: KY 43358) | |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0070287) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-02-21 |