| NPI | 1285070771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 52785) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0060678) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.138110) | |
| Enumeration Date | 2013-05-11 |
| Last Update Date | 2021-08-03 |