| NPI | 1134163132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD459671) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35083743) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-08-31 |