| NPI | 1518950203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.076064) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35-07-6464) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2023-11-03 |