| NPI | 1952336034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 90617) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101055531) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-08-27 |