| NPI | 1700319464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MD D0107745) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0107745) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2026-07-29 |