| NPI | 1124346002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY R2444) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00799) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2016-10-05 |