| NPI | 1679929871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A160318) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 289792) |
| 208600000X Surgery (Licence: AZ R75527) | |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2025-08-07 |