| NPI | 1801473616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0077438) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 000000000) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0077438) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2026-08-03 |