| NPI | 1093795734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.076575) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35076575-P) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2010-04-05 |