| NPI | 1245545243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34009838) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR DO221026) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2025-01-23 |