| NPI | 1174727796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 48122) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34-008599) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2017-02-02 |