| NPI | 1174528970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 37067) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35-081018) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2026-08-05 |