| NPI | 1386083681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60944075) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57 . 023541) |
| 207X00000X Orthopaedic Surgery (Licence: OH 023541) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-03-21 |