| NPI | 1639707029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 58.031733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.031733) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2021-04-07 |