| NPI | 1669924858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 57028811) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57028811) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2024-05-16 |