| NPI | 1679890255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.145816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101260706) |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2022-10-27 |