| NPI | 1003809484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35-08-1039) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.081039) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2023-11-09 |