| NPI | 1396023289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD469314) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.120056) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2020-10-16 |