| NPI | 1871098236 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME168832) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.38993) | 
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.38993) | |
| Enumeration Date | 2018-03-28 | 
| Last Update Date | 2024-09-09 |