| NPI | 1760667810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.093191) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.093191) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NC RTL 117210) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2023-11-09 |