| NPI | 1477945004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.012592) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 00000000000000) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 34.012592) | |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2021-08-31 |