| NPI | 1538189733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 72012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35127496) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-07-18 |