| NPI | 1457528283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301086407) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57012482) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2011-08-26 |