| NPI | 1437442704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 50441) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.132105) |
| 207X00000X Orthopaedic Surgery (Licence: WV 25371) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2019-08-20 |