| NPI | 1649419714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 5101021461) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 069925) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2023-11-06 |