| NPI | 1730162058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 23988) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 25345) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 23988) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2024-06-13 |