| NPI | 1295730588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.064933) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 35293) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2026-04-27 |