| NPI | 1225085962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35-05-8478) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 20394) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2016-05-10 |