| NPI | 1811263635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0071272) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: OR MD188782) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2023-09-05 |