| NPI | 1063581833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 18234) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-06-2182H) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-12-23 |