| NPI | 1033641147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 57655) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.135049) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-08-14 |