| NPI | 1770993206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.139825) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 54062) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2020-09-02 |