| NPI | 1932394186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR DO162272) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 58002398) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2018-07-24 |