| NPI | 1083093926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.015119) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS020496) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-07-24 |