| NPI | 1093135907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.135175) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 52028) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2025-12-30 |