| NPI | 1225234511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV DO1393) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 58.001229) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2008-06-02 |