| NPI | 1649561515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: VA 0101262349) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101262349) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2023-11-28 |