| NPI | 1972737153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60771590) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD-19296) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: HI MD-19296) | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2024-06-03 |