| NPI | 1891087425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA DO-06398) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 965) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA DO-06398) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2024-03-29 |