| NPI | 1013618651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 57.255896) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC Pending) |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2024-07-18 |