| NPI | 1295199131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.144816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 57171) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 62610) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-12-15 |