| NPI | 1710920590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34128548) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 6938629-1204) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-12-16 |