| NPI | 1821677733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 12949955-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.156354) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2026-06-16 |