| NPI | 1639269434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35038667) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: OH 35.038667) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-08-24 |