| NPI | 1285697896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35078203W) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-07-8203-W) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2019-07-25 |