| NPI | 1568472371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35052241) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: OH 35052241) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-05-22 |