| NPI | 1922283738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M9636) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 58001311) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2022-12-12 |