| NPI | 1316993686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 47936) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35083972J) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2021-08-03 |