| NPI | 1780262329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0076942) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0076942) |
| 207X00000X Orthopaedic Surgery (Licence: OK 38150) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2026-08-03 |