| NPI | 1487695722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35-036222) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35-036222) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35-036222) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2023-10-13 |