| NPI | 1013968742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 22602) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.098276) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-02-29 |