| NPI | 1649262536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX k5043) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX k5043) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX k5043) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2024-08-05 |