| NPI | 1710246905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 66735) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0058605) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036147319) | |
| 207X00000X Orthopaedic Surgery (Licence: ND 16942) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2026-02-06 |