| NPI | 1518146778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35.098711) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 013964) |
| 207X00000X Orthopaedic Surgery (Licence: TN 47340) | |
| 207X00000X Orthopaedic Surgery (Licence: TN MD47340) | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2012-12-04 |