| NPI | 1891788220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 34003097) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 3097) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2017-01-12 |