| NPI | 1548607302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.138823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 70901-20) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2021-03-23 |