| NPI | 1578907176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.132886) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036159642) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 2023-01664) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 2023-01664) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01087303A) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2025-07-18 |