| NPI | 1679795041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34004803) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 34-00-4803) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-11-24 |