| NPI | 1245210400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M12897) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.087310) |
| 207X00000X Orthopaedic Surgery (Licence: CA A78982) | |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2016-02-01 |