| NPI | 1265810733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 31497) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020010482) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: MO 2020010482) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2023-06-21 |