| NPI | 1598939175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 43267) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.012467) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 43267) | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: AZ 43267) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2024-04-23 |