| NPI | 1518079003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.055627) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35055627) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-05-25 |