| NPI | 1629026984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME65834) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL me 65834) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-10-09 |