| NPI | 1356877971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.016645) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 34.016645) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-06-19 |