| NPI | 1912176140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101254090) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.012988) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2020-09-12 |