| NPI | 1285126698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OT018467) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.016400) |
| 207X00000X Orthopaedic Surgery (Licence: KY 05513) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-06-23 |