| NPI | 1811125859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2013044289) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R2933) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2013044289) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2024-06-26 |