| NPI | 1063790657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.120538) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.120538) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 9732591-1205) | |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2024-10-22 |