| NPI | 1487697637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35126236) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 289005) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2026-02-13 |