| NPI | 1215277801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.013950) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP753) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 34.013950) | |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2026-03-09 |