| NPI | 1700055811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.1210260) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.121026) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2024-06-15 |