| NPI | 1568695047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WV 3015) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH FS1435189) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2018-11-27 |