| NPI | 1710911516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 35613) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 35613) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-08-03 |