| NPI | 1780975045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TX Q9413) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0056131) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-10-27 |