| NPI | 1508108713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.136578) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D85338) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2022-08-19 |