| NPI | 1811341936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.127505) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 48697) |
| 207X00000X Orthopaedic Surgery (Licence: ZZ 27700) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-11-17 |