| NPI | 1730672122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.46112) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.46112) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-06-13 |