| NPI | 1831178201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 30630) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K0460) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 30630) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX K0460) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-07-28 |