| NPI | 1003543810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.144622) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 56963) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 56963) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 35.144622) | |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-10-07 |