| NPI | 1053631192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35125492) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 47689) |
| 207X00000X Orthopaedic Surgery (Licence: IN 11015741A) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-05-08 |