| NPI | 1548675853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 04466) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.013643) |
| 207X00000X Orthopaedic Surgery (Licence: IN 02006325A) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-04-02 |