| NPI | 1023050093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 54425-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35087440) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-06-17 |