| NPI | 1952408767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.010800) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015355) |
| 207X00000X Orthopaedic Surgery (Licence: KY 03053) | |
| 207X00000X Orthopaedic Surgery (Licence: TN 2204) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-09-17 |