| NPI | 1194264861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101269040) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.136577) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2022-01-27 |