| NPI | 1154821080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 05846) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.016480) |
| 207X00000X Orthopaedic Surgery (Licence: KY TP119) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2024-11-05 |