| NPI | 1154412302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 82106-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-071501) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-07-13 |