| NPI | 1801093695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 201300691) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 53021) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2023-09-29 |