| NPI | 1366600561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.123927) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.123927) |
| 207X00000X Orthopaedic Surgery (Licence: NY 237424) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: KS 0434080) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KS 0434080) | |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2021-01-11 |