| NPI | 1871708255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 40324) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35089696) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2009-06-01 |