| NPI | 1801932447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35088370) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 230703) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-12-22 |