| NPI | 1346219672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 012343) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO r7898) |
| 207X00000X Orthopaedic Surgery (Licence: KS 05-21679) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-09-06 |