| NPI | 1104819861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35058405) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: OH 35058405) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2023-11-03 |