| NPI | 1710190673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2009-00316) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.085332) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-08-31 |