| NPI | 1043980543 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH APRN.CNP.026066) | 
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH APRN.CNP.026066) | 
| Enumeration Date | 2021-09-16 | 
| Last Update Date | 2023-07-12 |