| NPI | 1730375940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0051713) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 7976286-1205) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2021-02-24 |