| NPI | 1730455254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 34.011560) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL OS15496) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2020-02-03 |