| NPI | 1811067564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35081721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD066542L) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-08-02 |