| NPI | 1871835983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 96392) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101257332) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 96392) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-03-28 |