| NPI | 1821402819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 86015) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.136214) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2021-02-07 |