| NPI | 1932321924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 1228) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 58-001731) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2012-02-29 |