| NPI | 1922410166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 60620) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-10007) |
| 207X00000X Orthopaedic Surgery (Licence: AL MD.38113) | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2025-06-10 |