| NPI | 1639285109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.139315) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35.139315) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2021-03-18 |