| NPI | 1760776959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 63607) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 63607) |
| 208D00000X General Practice (Licence: HI MD-16591) | |
| Enumeration Date | 2011-06-05 |
| Last Update Date | 2021-09-23 |