| NPI | 1164424651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34008821) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS013247) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2023-03-07 |