| NPI | 1356309108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35062684) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 18940) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2024-08-27 |