| NPI | 1376749622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.094343) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101248988) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2021-01-29 |